Provider Demographics
NPI:1720549280
Name:GUPTA, ANJLIE ANIL (MD, MPHS)
Entity type:Individual
Prefix:DR
First Name:ANJLIE
Middle Name:ANIL
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD, MPHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 S RAMPART BLVD STE 360
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-5754
Mailing Address - Country:US
Mailing Address - Phone:702-724-2020
Mailing Address - Fax:
Practice Address - Street 1:330 S RAMPART BLVD STE 360
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-5754
Practice Address - Country:US
Practice Address - Phone:702-724-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-27
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV26429207W00000X
MA285426207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology